From 2000 to 2011 in prospective and retrospective studies we investigated pregnancy outcomes in all 30417 women treated within framework of the multidisciplinary management system for pregnant patients with cardiovascular diseases (hypertension, structural heart disease, aortic pathology and inflammatory autoimmune rheumatic diseases) designed and conducted in the Udmurt Republic of Russian Federation in late 1980-th. The system comprises specialized outpatient and inpatient departments, sanatorium and a maternity hospital at the regional cardiological center and provides ambulatory and hospital management and rehabilitation. Perinatal mortality decreased 65.8% from 11.1% in 2000 to 3.8% in 2011. Within 20 years no mother died.